114. Comparison of Waste Anesthetic Gas Exposures to Operating Room Staff During Cases Using Laryngeal Mask Airway (LMA'S) and Endotracheal Tubes (EET'S)

2002 ◽  
Author(s):  
M. Tortora
Keyword(s):  
Laryngeal Mask Airway ◽  
Operating Room ◽  
Laryngeal Mask ◽  
Endotracheal Tubes ◽  
Operating Room Staff

scholarly journals Corrected QT interval prolongation during anesthetic induction for laryngeal mask airway insertion with or without cisatracurium

2018 ◽  
Vol 46 (5) ◽  
pp. 1990-2000 ◽  
Author(s):  
Chengluan Xuan ◽  
Nan Wu ◽  
Yanhui Li ◽  
Xiaoting Sun ◽  
Qunshu Zhang ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Operating Room ◽  
Qt Interval ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Anesthetic Induction ◽  
Qt Interval Prolongation ◽  
Qtc Interval Prolongation

Objective This study was performed to observe the occurrence of corrected QT (QTc) interval prolongation during anesthetic induction for laryngeal mask airway insertion and the effects of cisatracurium administration on the QTc interval. Methods Eighty-eight patients were assigned to two groups: the cisatracurium administration group (n = 45) and non-cisatracurium administration group (n = 43). The QTc interval was continuously recorded by a 12-lead Holter electrocardiogram beginning in the hospital ward and continuing until after anesthetic induction. Results In the cisatracurium administration group, the QTc interval significantly increased from 417.9 ± 27.9 to 451.6 ± 32.5 ms after arrival in the operating room and significantly decreased to 432.4 ± 32.5 ms after a 15-minute rest; it significantly increased to 459.7 ± 23.8 ms again after propofol and fentanyl injection. However, the QTc interval decreased after cisatracurium injection. In the non-cisatracurium administration group, the QTc interval initially showed changes similar to those in the cisatracurium group until fentanyl and propofol were injected. Conclusions The QTc interval was significantly prolonged on arrival in the operating room and after propofol and fentanyl injection. The QTc interval did not significantly change by laryngeal mask airway insertion regardless of the administration of cisatracurium.

Endotracheal Intubation, but Not Laryngeal Mask Airway Insertion, Produces Reversible Bronchoconstriction 

1999 ◽  
Vol 90 (2) ◽  
pp. 391-394 ◽  
Author(s):  
Eun S. Kim ◽  
Michael J. Bishop
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Respiratory System ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Women Patients ◽  
Inhalation Anesthesia ◽  
Endotracheal Tubes ◽  
Respiratory System Resistance ◽  
End Tidal

Background Tracheal intubation frequently results in an increase in respiratory system resistance that can be reversed by inhaled bronchodilators. The authors hypothesized that insertion of a laryngeal mask airway would be less likely to result in reversible bronchoconstriction than would insertion of an endotracheal tube. Methods Fifty-two (45 men, 7 women) patients were randomized to receive a 7.5-mm (women) or 8-mm (men) endotracheal tube or a No. 4 (women) or No. 5 (men) laryngeal mask airway. Anesthesia was induced with 2 microg/kg fentanyl and 5 mg/kg thiopental, and airway placement was facilitated with 1 mg/kg succinylcholine. When a seal to more than 20 cm water was verified, respiratory system resistance was measured immediately after airway placement. Inhalation anesthesia was begun with isoflurane to achieve an end-tidal concentration of 1% for 10 min. Respiratory system resistance was measured again during identical conditions. Results Among patients receiving laryngeal mask airways, the initial respiratory system resistance was significantly less than among patients with endotracheal tubes (9.2+/-3.3 cm water x 1(-1) x s(-1) [mean +/- SD] compared with 13.4+/-9.6 cm water x 1(-1) x s(-1); P < 0.05). After 10 min of isoflurane, the resistance decreased to 8.6+/-3.6 cm water x 1(-1) x s(-1) in the endotracheal tube group but remained unchanged at 9.1+/-3.3 cm water x 1(-1) x s(-1) in the laryngeal mask airway group. The decrease in respiratory system resistance in the endotracheal tube group of 4.7+/-7 cm water x 1(-1) x s(-1) was highly significant compared with the lack of change in the laryngeal mask airway group (P < 0.01). Conclusions Resistance decreased rapidly only in patients with endotracheal tubes after they received isoflurane, a potent bronchodilator, suggesting that reversible bronchoconstriction was present in patients with endotracheal tubes but not in those with laryngeal mask airways. A laryngeal mask airway is a better choice of airway to minimize airway reaction.

Comparison of Mucosal Pressures Induced by Cuffs of Different Airway Devices

2006 ◽  
Vol 104 (5) ◽  
pp. 933-938 ◽  
Author(s):  
Herbert Ulrich-Pur ◽  
Franz Hrska ◽  
Peter Krafft ◽  
Helmut Friehs ◽  
Beatrix Wulkersdorfer ◽  
...  
Keyword(s):  
North America ◽  
Laryngeal Mask Airway ◽  
High Pressures ◽  
Laryngeal Mask ◽  
Esophageal Mucosa ◽  
Cuff Volume ◽  
Endotracheal Tubes ◽  
Tyco Healthcare ◽  
Intubating Laryngeal Mask Airway ◽  
Mucosal Pressure

Background High pressures exerted by balloons and cuffs of conventional endotracheal tubes, the Combitube (Tyco Healthcare Nellcor Mallinckrodt, Pleasanton, CA), the EasyTube (Teleflex Ruesch, Kernen, Germany), the Laryngeal Mask Airway (LMA North America, San Diego, CA), the Intubating Laryngeal Mask Airway (Fastrach; LMA North America), the ProSeal (LMA North America), and the Laryngeal Tube (LT; VBM Medizintechnik, Sulz, Germany) may traumatize the pharyngeal mucosa. The aim of this study was to compare pressures exerted on the pharyngeal, tracheal, and esophageal mucosa by different devices designed for securing the patient's airways. Methods Nineteen fresh cadavers were included. To measure mucosal pressures, microchip sensors were fixed on the anterior, lateral, and posterior surfaces of the proximal balloon and the distal cuff of the investigated devices. Depending on the respective airway device, the cuff volume was increased in 10-ml increments at the proximal balloon starting from 0 to a maximum of 100 ml, and in 2-ml increments at the distal cuff starting from 0 up to 12 ml. Results Tracheal mucosal pressures were significantly higher using the Combitube compared with the endotracheal tube and the EasyTube. Maximal esophageal pressures were significantly higher using the EasyTube compared with the Combitube. Using cuff volumes according to the manufacturers' guidelines, we found the highest pharyngeal pressures with the Intubating Laryngeal Mask Airway versus all other devices. At maximal volumes, the Laryngeal Mask Airway, the Intubating Laryngeal Mask Airway, and the ProSeal induced significantly higher pharyngeal pressures compared with all other devices. Using a pharyngeal cuff volume of 40 ml, the Intubating Laryngeal Mask Airway followed by the Laryngeal Mask Airway exerted significantly higher pressures compared with the other devices. Conclusions Although some devices exhibit a somewhat higher mucosal pressure when compared with others, the authors believe that the observed differences of the cuff pressures do not suggest a clinically relevant danger, because the investigated devices, except the endotracheal tubes, are not intended for prolonged use.

scholarly journals Adverse Events in Children Receiving General Anaesthesia with Laryngeal Mask Airway Insertion

2015 ◽  
Vol 53 (198) ◽  
pp. 77-82 ◽  
Author(s):  
Sindhu Khatiwada ◽  
Balkrishna Bhattarai ◽  
Krishna Pokharel ◽  
Asish Subedi
Keyword(s):  
Adverse Event ◽  
Laryngeal Mask Airway ◽  
Adverse Events ◽  
Operating Room ◽  
Respiratory System ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Cardiac Events ◽  
Early Management ◽  
Respiratory Events

Introduction: Perioperative adverse events are more common in children compared to adult population. Reporting an adverse event proves effective in identifying problems and helps in prevention and early management. Our objective was to identify the types, incidence, and the time of occurrence of perioperative adverse event. We also aimed to find out whether the occurrence of the types of adverse events differs in children below and above five years. Methods: This was a prospective study in 242, ASA Physical Status I and II children aged day one to 14 years, receiving general anesthesia with laryngeal mask airway for various elective surgeries. Adverse events observed in the perioperative period were recorded. Results: Adverse events related to respiratory system (n=26, 55%) were the most common followed by cardiovascular system (n= 14, 30%). Adverse events were observed in 24(10%) children in the operating room and in 20 (8%) children in the post anaesthesia care unit. In the operating room, majority (14 of 27, 52%) of the events occurred immediately after removal of laryngeal mask airway. Respiratory events were more common in children below five years (p=0.007), whereas cardiac events were more common in children above five years (p=0.02). Conclusions: The commonest adverse event in children is related to respiratory system. Adverse events occur more frequently in the operating room, mostly immediately after removal of laryngeal mask airway. Respiratory events are more frequent in children below five years whereas cardiac events are more frequent in children above five years.  Keywords: adverse events; children; laryngeal mask airway; laryngospasm; perioperative.

scholarly journals Safety and Efficacy of a Novel Intubating Laryngeal Mask during the recovery period following Supratentorial Tumour Surgery

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199976
Author(s):  
Xiaomei Ling ◽  
Xuemeng Chen ◽  
Gaowang Liu ◽  
Xianfeng Ma ◽  
Ming Xiao ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Bispectral Index ◽  
Recovery Period ◽  
Laryngeal Mask ◽  
The Novel ◽  
Laryngeal Masks ◽  
Safety And Efficacy ◽  
Endotracheal Tubes ◽  
Parallel Group ◽  
Surgical Drain

Objective To assess safety and efficacy of a novel intubation laryngeal mask airway (ILMA) during the recovery period following supratentorial tumour surgery. Methods Patients who underwent supratentorial tumour surgery at our centre from January 2012 to December 2016 were eligible for this prospective randomised, parallel group study. We developed a novel ILMA using closely fitting laryngeal masks (No. 4/5) with 7.0/7.5 mm endotracheal tubes (ETT) plus screw fixators and anti-pollution sleeves. Results In total, 100 patients were intubated with the novel ILMA and 100 the ETT. There were no differences between groups in haemodynamic variables, oxygen saturation, exhaled CO2, or bispectral index all recorded during the 72-hour recovery period. However, there were significantly fewer incidences of coughing, less fluid drainage and lower haemoglobin levels in surgical fluid in the ILMA group compared with the ETT group. Conclusion Our novel ILMA device was associated with reduced coughing, fluid drainage and blood in surgical drain during the recovery period following supratentorial tumour surgery.

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